Department of Clinical Medical Sciences, CEU-San-Pablo University School of Medicine, Madrid, Spain.
Department of Anesthesiology, Madrid-Montepríncipe University Hospital, Madrid, Spain.
Clin Anat. 2022 Apr;35(3):392-403. doi: 10.1002/ca.23845. Epub 2022 Feb 11.
Although the general functionality and structures of acupoints have been studied, there has been little insight into their underlying morphology and physical characteristics. We describe the microanatomical structures surrounding acupoints, the electron microscopic appearance of the needles, and the physical effects of acupuncture needling on the fascia. We injected heparinized blood solution through thin needles at seven known and commonly used "sweat acupoints" in eight fresh, unembalmed, cryopreserved human cadavers to mark the needle positions, and later, during histological examination, to identify them. After the solution was injected, samples were dissected and prepared for histological examination. We examined 350 cross-sections of five different paraffin wax sections from each acupoint microscopically. Acupuncture needles were photographed and superimposed on the cross-sectioned tissues at similar magnifications. Needles were also examined under a scanning electron microscope to judge the roughness or smoothness of their surfaces. A greater conglomeration of nerve endings surrounded the acupoints than in tissues more than 1-3 cm distant from them. Nerve endings and blood vessels were in close contact with a complex network of membranes formed by interlacing collagen fibers, and were always enclosed within those collagen membranes. Nerve endings were found within hypodermis, muscles, or both. Scanning electron microscopy demonstrated the three-dimensional shapes and sizes of the needles, and the degree of roughness or smoothness of their polished external surfaces. We demonstrate a delicate arrangement of nerve endings and blood vessels enclosed within complex collagen membrane networks at acupoints within the hypodermis and muscle. This arrangement could explain why needling is an essential step in the acupuncture process that provides favorable outcomes in clinical practice.
尽管已经研究了穴位的一般功能和结构，但对其潜在的形态和物理特性仍知之甚少。我们描述了穴位周围的微观解剖结构、针的电子显微镜外观以及针刺对筋膜的物理影响。我们将肝素化血液溶液通过细针注入八个未经防腐、冷冻保存的新鲜人体尸体中的七个已知和常用的“汗孔”穴位，以标记针的位置，然后在组织学检查中识别它们。在注入溶液后，对样本进行解剖并准备进行组织学检查。我们对来自每个穴位的五个不同石蜡切片的 350 个横截面进行了显微镜检查。拍摄了针灸针的照片，并将其以相似的放大倍数叠加在切片组织上。还使用扫描电子显微镜检查了针的表面粗糙度或光滑度。与距离穴位 1-3cm 以上的组织相比，穴位周围聚集了更多的神经末梢。神经末梢和血管与由交错的胶原纤维形成的复杂膜网络紧密接触，并且始终被包含在这些胶原膜内。神经末梢存在于皮下组织、肌肉或两者中。扫描电子显微镜显示了针的三维形状和大小，以及其抛光外表面的粗糙度或光滑度。我们证明了在皮下组织和肌肉内的穴位处，神经末梢和血管被包含在复杂的胶原膜网络中，这种排列可以解释为什么针刺是针灸过程中的一个必要步骤，它为临床实践提供了有利的结果。
